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1.
Sci Total Environ ; 699: 134383, 2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-31525545

RESUMO

The adverse effects of soil acidification are extensive and may result in hampered ecosystem functioning. Admixture of tree species with nutrient rich litter has been proposed to restore acidified forest soils and improve forest vitality, productivity and resilience. However, it is common belief that litter effects are insufficiently functional for restoration of poorly buffered sandy soils. Therefore we examined the effect of leaf litter on the forest floor, soil chemistry and soil biota in temperate forest stands along a range of sandy soil types in Belgium, the Netherlands and Germany. Specifically, we address: i) Which tree litter properties contribute most to the mitigation of soil acidification effects and ii) Do rich litter species have the potential to improve the belowground nutrient status of poorly buffered, sandy soils? Our analysis using structural equation modelling shows that litter base cation concentration is the decisive trait for the dominating soil buffering mechanism in forests that are heavily influenced by atmospheric nitrogen (N) deposition. This is in contrast with studies in which leaf litter quality is summarized by C/N ratio. We suggest that the concept of rich litter is context dependent and should consider Liebig's law of the most limiting: if N is not limiting in the ecosystem, litter C/N becomes of low importance, while base cations (calcium, magnesium, potassium) become determining. We further find that on poorly buffered soils, tree species with rich litter induce fast nutrient cycling, sustain higher earthworm biomass and keep topsoil base saturation above a threshold of 30%. Hence, rich litter can trigger a regime shift to the exchange buffer domain in sandy soils. This highlights that admixing tree species with litter rich in base cations is a promising measure to remediate soil properties on acidified sandy soils that receive, or have received, high inputs of N via deposition.


Assuntos
Fenômenos Ecológicos e Ambientais , Monitoramento Ambiental , Florestas , Animais , Bélgica , Biomassa , Alemanha , Países Baixos , Nitrogênio , Oligoquetos , Folhas de Planta , Solo/química , Árvores
2.
Br J Anaesth ; 124(2): 146-153, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31862160

RESUMO

BACKGROUND: Near-infrared spectroscopy non-invasively measures regional cerebral oxygen saturation. Intraoperative cerebral desaturations have been associated with worse neurological outcomes. We investigated whether perioperative cerebral desaturations are associated with postoperative delirium in older patients after cardiac surgery. METHODS: Patients aged 70 yr and older scheduled for on-pump cardiac surgery were included between 2015 and 2017 in a single-centre, prospective, observational study. Baseline cerebral oxygen saturation was measured 1 day before surgery. Throughout surgery and after ICU admission, cerebral oxygen saturation was monitored continuously up to 72 h after operation. The presence of delirium was assessed using the confusion assessment method for the ICU. Association with delirium was evaluated with unadjusted analyses and multivariable logistic regression. RESULTS: Ninety-six of 103 patients were included, and 29 (30%) became delirious. Intraoperative cerebral oxygen saturation was not significantly associated with postoperative delirium. The lowest postoperative cerebral oxygen saturation was lower in patients who became delirious (P=0.001). The absolute and relative postoperative cerebral oxygen saturation decreases were more marked in patients with delirium (13 [6]% and 19 [9]%, respectively) compared with patients without delirium (9 [4]% and 14 [5]%; P=0.002 and P=0.001, respectively). These differences in cerebral oxygen saturation were no longer present after excluding cerebral oxygen saturation values after patients became delirious. Older age, previous stroke, higher EuroSCORE II, lower preoperative Mini-Mental Status Examination, and more substantial absolute postoperative cerebral oxygen saturation decreases were independently associated with postoperative delirium incidence. CONCLUSIONS: Postoperative delirium in older patients undergoing cardiac surgery is associated with absolute decreases in postoperative cerebral oxygen saturation. These differences appear most detectable after the onset of delirium. CLINICAL TRIAL REGISTRATION: NCT02532530.


Assuntos
Encéfalo/metabolismo , Procedimentos Cirúrgicos Cardíacos , Delírio/etiologia , Avaliação Geriátrica/métodos , Oxigênio/metabolismo , Complicações Pós-Operatórias/etiologia , Idoso , Idoso de 80 Anos ou mais , Bélgica , Delírio/metabolismo , Feminino , Humanos , Masculino , Complicações Pós-Operatórias/metabolismo , Estudos Prospectivos , Espectroscopia de Luz Próxima ao Infravermelho
3.
Ned Tijdschr Tandheelkd ; 126(12): 637-645, 2019 Dec.
Artigo em Holandês | MEDLINE | ID: mdl-31840674

RESUMO

Oral care for older people is an underexposed topic in dentistry as well as in general healthcare, while oral care professionals are increasingly confronted with frail and multimorbid older people with complex care needs. The research agenda 'Oral care for the elderly' was developed to encourage the collaboration of researchers in the Netherlands and Flanders (Belgium) to do more research in this area and in this way, to achieve an expansion and implementation of knowledge. This will make possible the provision of a socially responsible and robust basis for sustainable oral care for frail older people. The focus of the agenda is on 3 themes, namely oral health and oral function for older people; multi/interdisciplinary collaboration within primary care and the costs, benefits and long-term effect(s) of oral care throughout the entire course of life. This article provides an overview of this research agenda and the way in which it has been established.


Assuntos
Assistência à Saúde , Atenção Primária à Saúde , Idoso , Idoso de 80 Anos ou mais , Bélgica , Idoso Fragilizado , Humanos , Países Baixos , Saúde Bucal
4.
Ned Tijdschr Tandheelkd ; 126(12): 665-671, 2019 Dec.
Artigo em Holandês | MEDLINE | ID: mdl-31840678

RESUMO

The ageing of the population in the Netherlands and in Belgium and the growing number of older people who still have their own teeth mean that dentists are seeing older patients in their dental practices increasingly often. Loss of cognitive abilities can hinder communication with the patients. Dementia and care-resistant behaviour demand a special patient-centred approach. In addition, frail older people are often dependent on carers or volunteers who actively participate in the conversation when the patient visits the dentist. This article addresses issues dentists should take into account in such cases. It also makes suggestions about how most effectively to direct communications with older patients and/or their companions.


Assuntos
Comunicação , Odontólogos , Idoso , Idoso de 80 Anos ou mais , Bélgica , Cuidadores , Humanos , Países Baixos
5.
Environ Health Perspect ; 127(11): 117001, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31691586

RESUMO

BACKGROUND: Although studies have provided estimates of premature mortality to either heat or cold in adult populations, and fetal exposure to ambient temperature may be associated with life expectancy, the effects of temperature on aging in early life have not yet been studied. Telomere length (TL) is a marker of biological aging, and a short TL at birth may predict lifespan and disease susceptibility later in life. OBJECTIVES: We studied to what extent prenatal ambient temperature exposure is associated with newborn TL. METHODS: In the ENVIRONAGE (ENVIRonmental influence ON early AGEing) birth cohort in Flanders, Belgium, we measured cord blood and placental TL in 1,103 mother-newborn pairs (singletons with ≥36wk of gestation) using a quantitative real-time polymerase chain reaction (qPCR) method. We associated newborn TL with average weekly exposure to ambient temperature using distributed lag nonlinear models (DLNMs) while controlling for potential confounders. Double-threshold DLNMs were used to estimate cold and heat thresholds and the linear associations between temperature and TL below the cold threshold and above the heat threshold. RESULTS: Prenatal temperature exposure above the heat threshold (19.5°C) was associated with shorter cord blood TL. The association with a 1°C increase in temperature was strongest at week 36 of gestation and resulted in a 3.29% [95% confidence interval (CI): -4.67, -1.88] shorter cord blood TL. Consistently, prenatal temperature exposure below the cold threshold (5.0°C) was associated with longer cord blood TL. The association with a 1°C decrease in temperature was strongest at week 10 of gestation with 0.72% (95% CI: 0.46, 0.97) longer cord blood TL. DISCUSSION: Our study supports potential effects of prenatal temperature exposure on longevity and disease susceptibility later in life. Future climate scenarios might jeopardize the potential molecular longevity of future generations from birth onward. https://doi.org/10.1289/EHP5153.


Assuntos
Envelhecimento/fisiologia , Temperatura Baixa , Sangue Fetal/fisiologia , Temperatura Alta , Exposição Materna , Placenta/fisiologia , Encurtamento do Telômero/fisiologia , Adulto , Bélgica , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , Longevidade , Masculino , Gravidez , Adulto Jovem
6.
Zootaxa ; 4571(4): zootaxa.4571.4.1, 2019 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-31715789

RESUMO

The type specimens of Lecithoceridae which are deposited in the Royal Museum for Central Africa (RMCA), Tervuren, Belgium (five species of Lecithocera Herrich-Schäffer and two of Homaloxestis Meyrick) were re-examined. The results are: 1) two species of Lecithocera are transferred to Thubdora Park and Torodora Meyrick respectively, with new combinations: Thubdora barbata (Meyrick, 1933), comb. nov. and Torodora semnodora (Meyrick, 1933), comb. nov.; 2) six species which were misidentified as L. barbata are described as new species in the genus Thubdora: T. ealeaensis sp. nov., T. ghesquierei sp. nov., T. gladiator sp. nov., T. kapangaensis sp. nov., T. neobarbata sp. nov. and T. seydeli sp. nov.; 3) four species which were misidentified as L. semnodora are described as new species in the genus Torodora: T. amplignathosa sp. nov. , T. lichanosa sp. nov., T. planusa sp. nov. and T. triloba sp. nov.; 4) L. schoutedeniella Ghesquière is transferred to Dichomeris Hübner of the family Gelechiidae; 5) Homaloxestis pancrocopa Meyrick does not belong to Homaloxestis nor to Lecithoceridae, and should be transferred to a different family of Gelechioidea; 6) a lectotype is designated for Lecithocera semnodora Meyrick, 1933; 7) the species names of Lecithocera eugenopa Meyrick and Homaloxestes chloromorpha Meyrick based on the type-labels under two specimens are revealed as unpublished manuscript names. Illustrations of the adults and their genitalia of all the types are provided.


Assuntos
Mariposas , Animais , Bélgica , Congo , Genitália , Museus
7.
Zootaxa ; 4649(1): zootaxa.4649.1.1, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31716932

RESUMO

A first comprehensive account on the dolichopodid fauna (Diptera: Dolichopodidae) of Portugal is presented as the result of multiple surveys by primarily Portuguese researchers between 2009 and 2016. All mainland Portuguese provinces and all districts but one (Évora) were investigated. A total of 761 dolichopodid samples were collected in 278 sampling sites distributed over 87 municipalities and 182 localities, with nearly ¾ of the samples gathered by sweep net. They contained 6,680 specimens of 200 different species, with 142 recognized (known), 40 new (undescribed) and 18 doubtful species. Medetera and Dolichopus were the most diverse among the recognized species, with 20 and 18 species respectively. Fourteen genera were represented by the new species, with Medetera as most diverse. The doubtful species included one species of Pelastoneurus, which is a first record of this genus for the Palaearctic realm. At present 208 dolichopodid species are known from Portugal. A checklist with 150 recognized species is presented, with first records of 116 species for Portugal. For nearly every species, information on its distribution, ecology and rarity in Portugal and northwestern Europe is given, as well as its seasonal activity in Portugal. Raw distribution data are available as dataset in GBIF. Seventy-five pictures of species in the field, and 15 habitat photos are also provided. Current data suggest that a higher proportion of Portuguese species are rare as compared to the Flemish fauna (northern Belgium). Both share 104 species, with 38 species only recorded from Portugal; only seven can be considered Iberian or Portuguese specialities. Though differences between the two Portuguese biomes cannot be substantiated at this moment, two very common and widespread European species, Campsicnemus scambus and Chrysotimus molliculus, seem to be restricted to the Eurosiberian biome in the northwest of the country. In terms of generic representation, the Portuguese dolichopodid fauna occupies an intermediate position between those of northwestern European and other Mediterranean countries. Despite the large amount of data gathered, the dolichopodid fauna of Portugal remains insufficiently known and a considerable number of additional known and new species can be expected with continued sampling.


Assuntos
Dípteros , Animais , Bélgica , Europa (Continente) , Portugal
8.
Bull Hist Med ; 93(3): 305-334, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31631069

RESUMO

Situated on the intersection of medicine and religion, postmortem caesarean sections exposed ideological boundaries in nineteenth-century medicine. According to clerical guidelines circulating in Catholic territories, Catholics who had not necessarily received medical training had to perform operations on deceased women in the absence of medical staff. Most doctors, on the other hand, objected to surgical interventions by unqualified Catholics. This article uses the Belgian debates about the postmortem caesarean section as a means to investigate methods of negotiation between liberal and Catholic doctors. The article analyzes, first, how doctors incorporated religious concerns such as baptism in the medical profession. Second, physicians' strategies to come to a compromise in ideologically diverse settings are examined. Overall, this article casts light on the dynamics of medical debate in times of both ideological rapprochement and polarization.


Assuntos
Catolicismo/história , Cesárea/história , Religião e Medicina , Bélgica , Cesárea/ética , Feminino , História do Século XIX , Humanos , Médicos/ética , Médicos/história
10.
Acta Gastroenterol Belg ; 82(3): 379-387, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31566325

RESUMO

BACKGROUND AND STUDY AIMS: Hepatitis C virus (HCV) infection often causes asymptomatic disease and patients are frequently diagnosed at an advanced stage. Oral direct acting antivirals (DAAs) are successful in treating HCV with high sustained virologic response (SVR) and excellent tolerability. The aim of this study is to evaluate cost-effectiveness of a broad screening strategy proposing screening to all undiagnosed members of a population (comprehensive HCV screening), in the general adult population, emergency department (ED) attendees, men who have sex with men (MSM) and people who inject drugs (PWID). PATIENTS AND METHODS: We populated a theoretical model with Belgian data. A decision tree model simulating HCV screening and diagnosis was combined with a Markov state transition model simulating treatment. There was one screening round per year during five years. In the ED population only one screening round was considered. RESULTS: The model calculated that more HCV patients could be detected and treated with comprehensive screening compared to the current situation. Incremental cost per incremental quality adjusted life years (QALY) gained was lower than 10.000€/QALY for one and for five screening rounds in the general population (5.139 and 5.200 respectively), in ED attendees (one screening round 5.967), in MSMs (4.292 and 4.302 respectively) and in PWIDs (3.504 and 3.524 respectively). CONCLUSION: A broad screening strategy combined with treatment is likely to be a cost-effective strategy to detect and treat HCV infected patients and diminish the HCV burden in Belgium.


Assuntos
Testes Diagnósticos de Rotina/economia , Hepacivirus/isolamento & purificação , Hepatite C/diagnóstico , Hepatite C/economia , Programas de Rastreamento/economia , Vigilância da População/métodos , Adulto , Antivirais/uso terapêutico , Bélgica/epidemiologia , Análise Custo-Benefício , Hepatite C/tratamento farmacológico , Humanos , Masculino , Programas de Rastreamento/métodos , Minorias Sexuais e de Gênero
12.
Arch Virol ; 164(12): 2919-2930, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31520220

RESUMO

Human bocavirus (HBoV) has been detected primarily in children with acute lower respiratory tract disease (LRTD), but its occurrence, clinical profile, and role as a causative agent of RTD are not clear. The aim of this study was to investigate the prevalence and the potential clinical relevance of HBoV. Using molecular tests, we tested 1352 nasopharyngeal samples obtained between October 1, 2017 and April 30, 2018 from children up to the age of 16 with RTD for the presence of HBoV DNA and 20 other respiratory pathogens at three different hospitals in Belgium. HBoV was detected in 77 children with a median age of 10.6 months. Consecutive samples were available for 15 HBoV-positive children and showed persistent HBoV positivity in four of them. Monoinfection was observed in six infants. Four of them were born prematurely and were infected during hospitalization at the neonatal intensive care unit (NICU). Only one of these six monoinfected children was diagnosed with recurrent wheezing due to HBoV. This child was carried to term and had a high viral load. Coinfections, most frequently with rhinovirus (52.1%) and adenovirus (49.3%), were observed in 72 patients. In seventeen of them in which HBoV was present at high viral load or higher viral load than its copathogens, bronchi(oli)tis (n = 8), recurrent wheezing (n = 8) or episodic wheezing (n = 1) were diagnosed. Our results suggest that HBoV infection at high viral load in infants is associated with wheezing (P = 0.013, Cramer's V = 0.613).


Assuntos
Bocavirus Humano/isolamento & purificação , Infecções por Parvoviridae/diagnóstico , Infecções Respiratórias/virologia , Adolescente , Bélgica/epidemiologia , Criança , Pré-Escolar , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/virologia , DNA Viral/genética , Feminino , Bocavirus Humano/genética , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Masculino , Nasofaringe/virologia , Infecções por Parvoviridae/epidemiologia , Nascimento Prematuro/epidemiologia , Nascimento Prematuro/virologia , Prevalência , Estudos Retrospectivos , Carga Viral
13.
Tijdschr Psychiatr ; 61(9): 626-634, 2019.
Artigo em Holandês | MEDLINE | ID: mdl-31560782

RESUMO

BACKGROUND: Only 0.8% of the admissions to our mother-baby unit are mothers with schizophrenia, while about half of the patients with schizophrenia become mothers. Mothers with schizophrenia are more likely to live in complex problematic settings and, thereby, more frequently lose custody of their children. Also, they experience stigma against their parenting skills. Literature research shows that they therefore avoid care. However, the inclusion of their role as a mother can contribute to recovery, giving meaning and social integration.
AIM: To initiate debate on responsible motherhood in women with schizophrenia with the aim of optimizing the Flemish care provision and give an incentive towards more scientific research.
METHOD: Consultation of the minimal psychiatric data (mpd) on our mother-baby unit. Narrative literature search using PubMed with a focus on schizophrenia in the peripartum.
RESULTS: Mothers who suffer from schizophrenia are more likely to experience difficulties in social cognition and sensitivity to their children. These problems can make the relationship between mother and baby more difficult. However, this does not exclude the possibility of developing a positive attachment relationship.
CONCLUSION: A persistent case manager-driven care model, which monitors the care for this vulnerable population and focuses on reinforcing the parenting qualities, looks promising. As a result, (shared) responsible motherhood could have a positive impact on their recovery.


Assuntos
Relações Mãe-Filho , Mães/psicologia , Assistência Perinatal , Psicologia do Esquizofrênico , Adulto , Bélgica , Feminino , Humanos , Lactente , Recém-Nascido , Saúde Mental , Relações Mãe-Filho/psicologia , Poder Familiar , Gravidez , Esquizofrenia
14.
Maturitas ; 128: 60-63, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31561825

RESUMO

INTRODUCTION: The interpretation of the literature on menopause hormone therapy (MHT) has evolved enormously over the last decade. In recent years, guidelines have reinstated the place of MHT. AIM: This survey analyzes the prescription (initiation and maintenance) of MHT in relation to patient age and therapy indications. MATERIAL AND METHOD: Two vignettes were sent to gynecologists working in Belgium in a random survey. One vignette concerned the initiation of therapy for a woman who was either 52 or 62 years old, suffering either from severe vasomotor symptoms (VSM) or from osteoporosis. The second vignette concerned the maintenance of MHT or switching to another medication in a woman aged 62 years who suffered either from VSM (when stopping MHT) or from osteoporosis. The physicians were asked how they would treat these two patients. RESULTS: We analyzed 443 vignettes from 222 physicians. INITIATION OF MHT: 84% of the respondents would initiate MHT for a 52-year-old woman with VMS, whereas only 32% would do so for a 52-year-old woman who had osteoporosis (chi square = 33; p < 0.001). 51% would initiate MHT for a 62-year-old woman with VMS, whereas only 14% would do so for a 62-year-old woman with osteoporosis (chi square = 17; p < 0.001). MAINTENANCE OF THERAPY: 87% would maintain MHT for a 62-year-old woman with severe VMS and 52% would do so for a 62-year-old woman with osteoporosis (Chi Square 31; p < 0.001). CONCLUSION: VMS are recognized as an indication for MHT, but osteoporosis much less so, even for women around the age of 50.


Assuntos
Atitude do Pessoal de Saúde , Ginecologia , Terapia de Reposição Hormonal , Menopausa , Osteoporose Pós-Menopausa/tratamento farmacológico , Fatores Etários , Bélgica , Feminino , Pesquisas sobre Serviços de Saúde , Humanos , Pessoa de Meia-Idade
15.
Nat Commun ; 10(1): 3866, 2019 09 17.
Artigo em Inglês | MEDLINE | ID: mdl-31530803

RESUMO

Particle transfer across the placenta has been suggested but to date, no direct evidence in real-life, human context exists. Here we report the presence of black carbon (BC) particles as part of combustion-derived particulate matter in human placentae using white-light generation under femtosecond pulsed illumination. BC is identified in all screened placentae, with an average (SD) particle count of 0.95 × 104 (0.66 × 104) and 2.09 × 104 (0.9 × 104) particles per mm3 for low and high exposed mothers, respectively. Furthermore, the placental BC load is positively associated with mothers' residential BC exposure during pregnancy (0.63-2.42 µg per m3). Our finding that BC particles accumulate on the fetal side of the placenta suggests that ambient particulates could be transported towards the fetus and represents a potential mechanism explaining the detrimental health effects of pollution from early life onwards.


Assuntos
Poluentes Atmosféricos/metabolismo , Exposição Materna/efeitos adversos , Troca Materno-Fetal , Placenta/metabolismo , Fuligem/metabolismo , Poluentes Atmosféricos/toxicidade , Bélgica , Biópsia , Estudos de Coortes , Ecotoxicologia , Feminino , Humanos , Microscopia Eletrônica de Transmissão , Permeabilidade , Placenta/patologia , Placenta/ultraestrutura , Gravidez , Características de Residência/estatística & dados numéricos , Fuligem/análise , Fuligem/toxicidade
17.
Chemosphere ; 236: 124407, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31545204

RESUMO

The widespread use of perfluoroalkylated acids (PFAAs) has led to a global presence in the environment, in which they accumulate and may cause detrimental effects. Although soils are known sinks for many persistent organic pollutants, still little is known on the behaviour of PFAAs in soils. Furthermore, studies that examine the relationships between PFAA concentrations and soil microbial parameters are scarce. The 3 M fluorochemical plant near Antwerp has been characterized as a PFAAs hotspot. In the present study, we examined the vertical distribution of 15 PFAAs and their associations with multiple physicochemical soil properties along a distance gradient from this hotspot. Additionally, we tested the relationships between PFAA concentrations in the top soil with soil respiration, microbial activity and microbial biomass. Our results show that both perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) concentrations were elevated in the subsurface layer (up to 50 cm), after which concentrations decreased again, suggesting a downward migration of both analytes in the soil. This downward movement might pose a potential threat for the contamination of the groundwater and, consequently, organisms that rely on this water for consumption. The soil concentrations were influenced by multiple physicochemical properties of the soil, which suggests differences in bioavailability and sorption/desorption capacities between different soil types. We did not observe any influence of PFAA contamination in the top soil on microbial activity and biomass nor soil respiration.


Assuntos
Indústria Química , Fluorcarbonetos/análise , Microbiologia do Solo , Poluentes do Solo/análise , Solo/química , Ácidos Alcanossulfônicos/análise , Bélgica , Caprilatos/análise , Carbono/análise , Argila , Concentração de Íons de Hidrogênio , Temperatura Ambiente
18.
BMC Health Serv Res ; 19(1): 637, 2019 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-31488147

RESUMO

BACKGROUND: We examine the implications of reducing the average length of stay (ALOS) for a delivery on the required capacity in terms of service volume and maternity beds in Belgium, using administrative data covering all inpatient stays in Belgian general hospitals over the period 2003-2014. METHODS: A projection model generates forecasts of all inpatient and day-care services with a time horizon of 2025. It adjusts the observed hospital use in 2014 to the combined effect of three evolutions: the change in population size and composition, the time trend evolution of ALOS, and the time trend evolution of the admission rates. In addition, we develop an alternative scenario to evaluate the impact of an accelerated reduction of ALOS. RESULTS: Between 2014 and 2025, we expect the number of deliveries to increase by 4.41%, and the number of stays in maternity services by 3.38%. At the same time, a reduction in ALOS is projected for all types of deliveries. The required capacity for maternity beds will decrease by 17%. In case of an accelerated reduction of the ALOS to reach international standards, this required capacity for maternity beds will decrease by more than 30%. CONCLUSIONS: Despite an expected increase in the number of deliveries, future hospital capacity in terms of maternity beds can be considerably reduced in Belgium, due to the continuing reduction of ALOS.


Assuntos
Número de Leitos em Hospital/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Adulto , Ocupação de Leitos/estatística & dados numéricos , Bélgica , Parto Obstétrico/estatística & dados numéricos , Parto Obstétrico/tendências , Feminino , Previsões , Hospitais Gerais/estatística & dados numéricos , Hospitais Gerais/tendências , Humanos , Tempo de Internação/tendências , Pessoa de Meia-Idade , Gravidez
19.
Psychiatr Danub ; 31(Suppl 3): 371-375, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488754

RESUMO

BACKGROUND: In this paper we focus on adolescents in transition towards young adulthood (ATYA). We know from international studies that the transition process makes adolescents vulnerable to mental illness. However, little is known about Belgian ATYA mental-health status. Nor are risk factors associated with their mental illness understood, in particular with regard to depressive and anxiety disorder. The aim of this study is (1) to discuss evolution in time of prevalence of depressive disorder (DD) and anxiety disorder (AD) among Belgian ATYA and (2), to identify risk factors associated with these disorders among ATYA. SUBJECTS AND METHODS: Data was extracted from the Belgian Health Interview Survey (BHIS), which is a cross-sectional population survey, carried out in 2001, 2004, 2008, and 2013. Information about the population's background characteristics, health services utilization, health behaviours and mental health status were extracted and statistically analyzed. RESULTS: ATYA prevalence of DD and AD was higher in 2013 in comparison with previous years. These changes were significant only for DD (F=4.466, p=0.004). In contrast with younger adolescents, among ATYA odds of DD were 28.2% higher (OR 1.282, 95% CI 0.967-1.698, p=0.084) and, odds of AD were 55.2% higher (OR 1.552, 95% CI 1.137-2.119, p=0.006). For ATYA, a poor quality of social support was the most predictive factor of DD (OR 11.187, 95% CI 5.530-22.629, p<0.0001) and AD (OR 6.238, 95% CI 2.845-13.676, p<0.0001); whereas, having a paid job was the most protective factor with regard to DD (OR 0.282, 95% CI 0.169-0.470, p<0.0001) and AD (OR 0.552, 95% CI 0.330-0.924, p<0.024). CONCLUSION: Prevalence of mental illness among Belgian ATYA appears to worsen in time. In comparison with younger adolescents, ATYA are more vulnerable to anxiety disorders. Adverse and protective risk factors were identified and discussed in a way to improve access, continuity and mental healthcare pathways for Belgian ATYA.


Assuntos
Transtornos de Ansiedade/epidemiologia , Transtorno Depressivo/epidemiologia , Nível de Saúde , Saúde Mental/estatística & dados numéricos , Adolescente , Bélgica/epidemiologia , Estudos Transversais , Emprego/estatística & dados numéricos , Comportamentos Relacionados com a Saúde , Pesquisa sobre Serviços de Saúde , Humanos , Prevalência , Fatores de Risco , Adulto Jovem
20.
Psychiatr Danub ; 31(Suppl 3): 395-399, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488759

RESUMO

BACKGROUND: According to the United Nations High Commissioner for Refugees the number of people forced to leave their home as a result of conflict, persecution, violence or human rights violations remains high with 68.5 million forcibly displaced people worldwide. Asylum seekers are vulnerable in terms of mental health but they receive very little specific psychiatric care. The purpose of this literature review is to examine current situation regarding asylum seekers' psychiatric healthcare. SUBJECTS AND METHODS: This research was conducted using a keyword search on Medline, PubMed and Google Scholar. RESULTS: The literature on the management of the mental health of asylum seekers focuses on the issue of post-traumatic stress disorder. There is little data on other forms of mental illness in this population. The prevalence of post-traumatic stress disorder among asylum seekers is higher than in the general population and its clinical expression is varied and often complex because it involves various vulnerability factors. Guidelines for post-traumatic stress disorder recommend cognitive behavioral therapy with, in some cases, the use of pharmacotherapy. Given the specificities of the asylum seekers' population, in many cases it is not possible to set up such therapy immediately. Asylum seekers face a number of challenges in accessing mental healthcare. CONCLUSION: Management of the mental health of asylum seekers requires special attention and guidelines for the general population are not directly applicable to this specific population. The literature focuses on the issue of post-traumatic stress disorder. This review was not able to analyse the state of existing care offer in Belgium for managing the mental health of asylum seekers and the care pathways they take.


Assuntos
Saúde Mental , Psiquiatria , Refugiados/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Bélgica , Humanos , Saúde Mental/estatística & dados numéricos , Prevalência , Psiquiatria/organização & administração , Psiquiatria/estatística & dados numéricos
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